How are people with liver mets doing?
Comments
-
Dear Zarovka,
Happy to read that you got over the healing crisis and are feeling better now.May you continue to successfully respond to TX and fasting combination.
LeftFoot—Kaption....I know how you feel....it's only 3 years since diagnosis for me and I feel so tired at times at the routine scans, TX and increasing SE, but we must endure and be strong, soon, somewhere, someone will figure out the real cause and the right TX's.
Best of luck to both of you and the rest of our community
0 -
Thank you, leftfootforward. It’s nice to be understood. Take care.
Hugs to you too.
0 -
Kaption, you’re not being a downer, just living with it all and I would be the same. I’ve had two fails in less than two years and just that is frustrating, I can’t imagine where I would be in your shoes! I’m hoping you continue to get some response until the next new thing comes along! Pulling for you!!!
0 -
Zar i love how you explain it all, and really have a handle of how you feel. It's truly a great selfless act for you to spend that time with the fam for the kids. ( On an aside my other w DD are going to Colorado at the end of July, parteee time, if you have any tips i'll give it over, they are visiting the parks, driving to Lake Powell and God only knows what else).
You know, the people you are closest to may not know or understand sometimes how much you need them to GET you, and yes, it's too bad. I just got this from the sweetest fam member - Time will heal ( i was telling her how hard was to see the girls when they don't feel well blah blah), im telling you i wanted to smack her, i said - WE DON'T want time to heal anything!!!!!!!!!!!!! These ppl, and usually the ones closest to you, can't see you hurt so they go bonkers. How i wish they would understand. My girls and I, NEED to feel Dani with us alllllllllll of the time, we are still doing the requested stuff, but we are thinking of her every instant of every moment of every second...
Waiting with you on the liver stuff!
Kaption it's worrisome, but for now you have the now, and there are more things in your future if need be.
Hugs to all of the special ladies.
0 -
Oh Kaption,
I totally understand. This whole thing is so wearing on body and spirit. I'm only a year in with 3 drug failures under my belt and massive progression with each fail.
When I met with my oncologist he was so hopeful for the future. He sees so many good things on the horizon. Our job is to keep plugging even when the day ahead seems bleak. It seems pollyannaish but I brainwash myself into thinking it will get better.
Hang in there. I'm praying for you.
Mary
0 -
Zarovka,
I'm so glad you're feeling better. 11,000 feet for any extended period is hard on everyone.
Anxious to hear about your scans. Looking at weekly taxol and trying to figure out some kind of modified fasting regimen.
I admire your spirit.
Mary
0 -
Finally some signs of intelligence.
Top oncologist to study effect of diet on cancer drugs
A groundbreaking clinical trial on whether diet could boost the effectiveness of cancer drugs is set to be launched by one of the world's leading…
Read it on Flipboard
Read it on theguardian.com
The patients will be treated with a licensed drug, Aliqopa, that has previously been shown to have limited effects in such patients. However, recent animal studies, including a paper this week in Nature from Mukherjee's lab, suggest its effectiveness could be significantly boosted when combined with diet changes aimed at lowering insulin levels.
“To achieve this, patients will be put on a so-called ketogenic diet (high in fat, low in carbohydrate, normal protein). "If you combine them with a diet which [keeps insulin low], all of a sudden these drugs become effective," said Mukherjee, referring to the Nature study. "The diet really works like a drug."
In some cases, Vousden added, what might intuitively seem correct – giving patients on chemotherapy a sugary drink, say – might not be the optimal way to boost calorie intake. "We want to champion the idea that you give dietary advice based on hard evidence," she said. ( no shit! Sherlock! can't make this stuff up folks!)
Maybe one day, hopefully soon, they will study the effect of ingesting processed sugary foods on the growth of cancers. Meanwhile if you don't want to wait, you can achieve the same effect by taking Metformin or Berberine, the natural over the counterequivalent.
This is the reason why the diet and the Metformin are effective: Biguanides enhance antifungal activity against Candida.
Repurposing Metformin as an anti-cancer agent: microgravity studies in Saccharomyces cerevisiae (Drug Metabolism) - 07.12.17
Metformin is a drug commonly used to treat type 2 diabetes, which is often associated with obesity. Along with lowering blood sugar and cholesterol, metformin has been shown to protect diabetic patients against several forms of cancer. Repurposing Metformin as an anti-cancer agent: microgravity studies in Saccharomyces cerevisiae studies yeast cells to understand how drugs act on tumors, and whether metformin can serve as an anti-cancer drug.0 -
MIaoMix- Very exciting news! The drug companies have spent billions trying to get a PI3K inhibitor that really works. All we have is affinitor, which should work way better than it does. This study says taking the drug in very low sugar conditions makes it work way way better. So that means eating a low sugar diet, or an alternative is to do a longer nightime fasting. Instead of "take with food", the label might say "take while fasted".
Studies in mice show that if there is a long fasting period (for humans it would mean something like "nothing but water after 6pm", for example), then the diet during the day can be normal, ie no change to normal is required. Trials in humans show restricted feeding/nightime fasting leads to a drop of about 1.5 points in A1C levels, which is often better than one can get with drugs. And we knew that the PI3K drugs have this problem, because high blood sugar is a side effect and people are sometimes put on metformin. Instead, maybe we can just take the drug at night, after a short 2-3 hours water-only fast, and continue fasting till daytime. Drug efficacy can be wildly different depending on the sugar level.
For those keeping count, this is the third news report out this week on possible ways to boost the activity of PI3K inhibitors:
1) Take in low sugar. 2) Combine with an Aurora A kinase inhibitor, or 3) Combine with Neratinib (HER2,3) inhibitor.
And of course we want to add in with Faslodex, because once the PI3K/mTOR pathway is inhibited, the cells become dependent on estrogen again. So in the future we already may be taking PI3K inhibitors as part of a 3 way combo- (ie. PI3K inhibitor + Faslodex + AuroraA inhibitor or Neratinib)- if so, adding in control of the diet or fasting could be the only possible way to fit in another treatment!
0 -
cure-ious thank you for your detailed explanation regarding the importance of PK13 inhibitors. I have to confess my utter ignorance regarding the science. But I'm happy to feel your enthusiasm and I'm hoping you're right about this possibly becoming the breakthrough we need.
My own research is leading me to other conclusions and I'm currently experimenting on myself by persuing a lowcarb, antifungal diet replete with probiotics and Metformin. It might not reduce the cancer load, but I figure it should at least reduce the chances of dying from an opportunist infection during an emergency in a hospital or while eating out at a restaurant.
I'm just happy to see confirmed that a low carb diet in combination with an antifungal ( Metformin) makes cancerTx more effective. I’m currently on xeloda.
0 -
Well, we are all experimenting on ourselves! Keep reading and thanks for the update, I always learn so much on these threads!!
0 -
The plot thickens....
Cancer diagnosis tied to increased risk of diabetes
(Reuters Health) - People who get diagnosed with cancer may be more likely to develop diabetes, a Korean study suggests. The study included 524,089…
Gallbladder and lung tumors were associated with at least a 70 percent greater risk of diabetes. Breast, thyroid and stomach malignancies were also tied to an increased risk of diabetes.
"Cancer therapies such as steroids, and many chemotherapy and radiotherapy regimes can increase glucose (or blood sugar) levels," Chowdhury said. "This may in part explain the link."
I personally experienced out of control blood sugar levels while on Afinitor that Metformin could not control.
Read it on Flipboard
Read it on reuters.com
0 -
Hi - I am a follower of this thread since mets DX in February - but don’t post too often. Wondering if anyone knows any names of the Aurora A kinase drugs. Research I’ve done shows early trials but is there anything already available? Has the drug become “standard of care”?
0 -
Hi Ann,
Good questions, I will look around. In the time since you were just diagnosed in Feb, what treatments have you had or are you taking now? I ask because a PI3K/mTORC1 inhibitor plus Aurora A kinase combo would be at something to look for after you are finished with the Ibrance/CDK4,6 inhibitors, the sequence for that is important
0 -
There is a phase 2 trial of Alisertib (Aurora A kinase inhibitor) with Faslodex (but no mTOR inhibitor was included in this trial), which is full and not recruiting. In phase 1 of that trial, they treated nine women, all of whom had previously progressed on AIs/Faslodex alone- the overall PFS was a bit over a year, with 78% getting some benefit by six months and one patient still on treatment at 31 months. SEs were the usual neutropenia. Given the new data just reported, t would be great if they opened up another arm adding in Affinitor or a newer generation mTOR inhibitor to the Alisertib-Faslodex combo.
0 -
Cure-ious, I asked my onc at our last appt. if after the Abraxane, things were a little better under control if he would ever go back to Ibrance. He said no because there weren’t any studies. But isn’t there something out there (sorry, medical illiterate!) that says you can go back if the estrogen is still positive?
0 -
Gracie Some ONCs do circle back to some combos with anti-estrogens after different treatments but there are many others here who know better than I do about that and in particular about the case of following Abraxane, so hopefully people chime in..
0 -
Ok tganks Cure-ious. I was thinking I saw a conversation somewhere about the estrogen becoming sensitive to AI’s again after some other chemo. My cancer still shows ER+ but the AI’s haven’t made much difference
0 -
Cur-ious- thanks for your help. since mets dx this past Feb I was on ibrance/ Faslodex for 3 months. PET scan showed mixed results in bone and liver mets with new adrenal mets. Have been on Halavan since. Prior to mets since 2013 had ACT, rads, BM and one year of Xeloda (did not fail it MO just wanted to try AIs). Tried all AIs plus tamoxifen but had a lot of SE with each so kept trying different ones till Arimedix had the fewest but then progression.
I had similar thoughts about Faslodex/AIs plus Aurora, but adding th mTOR would be even better - if SE wouldn’t be too bad. Would u be able to give the web site for the phase 2 trial...so I can closely monitor for the start of phase 3 if there is one? Your help is so greatly appreciated. I can spend hours and not find anything - then get confused and exhausted. Being a cancer patient is hard from so many perspectives
This is probably a stupid question but would anyone know if or why not they are not targeting PI3k/m for immunotherapy treatment?
0 -
Cure-ious, the Phase 2 trial I have been in for almost two years is for Alisertib paired with paclitaxel. I am in the chemo-only arm of the trial so I'm not taking Alisertib. It is also full and closed now, and no data has been released. I would love to know how it's shaping up, but in the meantime what you report here about the Alisertib/Fas trial is encouraging.
0 -
Welcome SusieM49. You have come to the right place as there are very amazing people on this thread. I was Dx mets in February so I’m pretty new but have learned a lot from everyone. Support during this journey is so important and this is my go to site. Questions are good because the answers help many!
0 -
Wow, Lulubee, you have been Stage IV for eight years?!! Incredible!!
And yes, Ann, the thing we all are missing out on (so far) is some immunotherapy!
There is a trial some of us here have been following closely that combines Abemaciclib(CDK4,6) inhibitor with Keytruda- the little information we can find indicates that the combo might be about 2-3x as good as Abemaciclib alone, which, if true, would be the first indication of a response for HR-positive MBC!! The idea of the combo is based on excellent pre-clinical data showing that CDK4,6 inhibitors synergize well with immunotherapy.
So that might be a good trial while waiting for the PI3K inhibitors to show some of their big promise.Here is a link to the trial locations- it requires at least one, but not more than two, chemos in the metastatic setting; the trial should be over this time next year:
https://clinicaltrials.gov/ct2/show/study/NCT02779...
Will look for any combos with PI3K inhibitors that might involve immuno; that's a good question!
0 -
Yes, Cure-ious, 8 years at Stage IV, and yes it is incredible.
FYI on Alisertib, I learned something interesting today. My research liaison nurse told me that the drug company decided a while back to discontinue production of Alisertib. I asked her why the trials were continuing for a drug that is not in production and she kind of shrugged, said sometimes the hope is that the trial results will be compelling enough to persuade the drug company to go back into production.
0 -
Its made by Takeda, a company in Japan, who have been trying to show some application for the drug for quite a few years and after several failed trials, its not surprising- hopefully they will now reconsider with brand-new data out there saying that you need to have an Aurora A kinase inhibitor in order to make mTOR inhibitors work. If not, somebody else will surely jump into the mix, because the market for mTOR inhibitors is so HUGE, just for MBC alone the estimate is at least 60% of patients have the problem of overactive mTOR kinase, esp high in the cancer cells that become resistant to endocrine therapies.
0 -
Cure-ious- Do you know if there is any research about Aurora A Kinese inhibitor being used with MTor after Mtor has failed?
0 -
I haven't seen that specifically in this case, but for trials using the other combos, they have seen them work when the monotherapy failed. And in this case, they see that the reason mTORC inhibitors fail is because Aurora A Kinase levels are too high, so by definition the drug did not have a chance to work, and the combo would get at the reason for the resistance.
0 -
Interesting. Maybe there is hope. Everolimus was supposed to help me according to Foundation 1 but did absolutely nothing - had huge progression over the 9 weeks I was on it. Doctor mentioned possibility of an Aurora A Kinase inhibitor trial, but I think none of this will work alone for me.
0 -
Cure-ious - thanks for the info and thanks all for sharing your experiences!
Marylark- my testing also showed everolimus is supposed to help but will have to wait and see. I had Mixed response on I/F so i think something else is still driving the bus into the ditch! My MO told me there wouldn’t be a cure for me - just what I wanted to hear ☹️. But if I can get 8 years- that would be great! How is the trial you are on
0 -
There was an interesting paper on aurora kinase inhibitors listing all the drugs on trial. It was from 2015 so it would be nice to check where we are now with each of them.
0 -
ann1999 -I'm not in a trial yet. We're still looking at a couple of options: the Aurora A Kinase inhibitor, Immu-132 (antibody-drug conjugate- still trying to figure out what that does), Radium 223 for my substantial bone mets, or a BET inhibitor. Since I've had quick progression on all targeted therapies and only minor success on Xeloda (knocked out my one tiny liver met but with substantial progression in bone), I'm nervous about any targeted therapy. Taxol is on the table, which I would be fine with. I have to wait for counts to go up after Afinitor as I have to have surgery to put a rod in my tibia as most of the bone has been destroyed by the mets. Two weeks seems like a lifetime when mets are going crazy. I'll keep you posted on what if any trial I land in.
0 -
Sorry about that Marylark. I hope you find the one that works for u a long long time
0
